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Biomedical subjects

K Perrett

Publications and source records attributed to K Perrett.

10 recordsLinked to original sources
PubMed2004

Group A streptococcal bacteraemia in Yorkshire and the Humber: evidence of another problematic infection among injecting drug users.

It has been estimated that in England and Wales, in 2002, 15% of all invasive group A streptococcal (GAS) cases were amongst injecting drug users (IDUs). This study sought to clarify the extent of this problem in the Yorkshire and Humber region by asking laboratories for further information on reported cases. In our region we found that there was a near doubling of cases, from 64 reports of GAS bacteraemia in the first six months of 2001, to 121 reports in the same period of 2003. We estimated that 34% of all GAS cases, more than twice the previous national estimate, occurred in IDUs and that the proportion of cases occurring in IDUs nearly doubled from 2001 to 2002. Our findings should be viewed within the context of the increasing reports of several other problematic infections in IDUs.

Adolescent↗
PubMed2003

Changing epidemiology of hepatitis A: should we be doing more to vaccinate injecting drug users?

Since 2001 there have been significant outbreaks of hepatitis A virus (HAV) across South Yorkshire, largely in intravenous drug users, and HAV infection has been reported to be an increasing problem in England and Scotland during this time. This paper reports a brief investigation to clarify current HAV epidemiology in England and Wales. The epidemiology of HAV in England, but not yet Wales, has recently changed. Laboratory reports now show that most cases are occurring in young adults, mainly young men, and that the commonest reported risk group is injecting drug users. That cases may now be concentrated in injecting drug users is supported by reports from consultants in communicable disease control (CsCDC). These detail fourteen outbreaks in England in 2002 alone, all involving injecting drug users. Links to prisons and to the homeless, usually those in hostels, were also common. A combined Hepatitis A/B vaccine is readily available and we recommend that this now be used to extend the national immunisation programme against Hepatitis B in injecting drug users to include HAV.

Adolescent↗
PubMed2000

Outbreak of meningococcal disease in Rotherham illustrates the value of coordination, communication, and collaboration in management.

On New Year's Eve 1998, two teenagers from the same school in Rotherham died of serogroup C meningococcal septicaemia. A third linked case occurred three days later. Over eight days starting on New Year's Eve, a further five cases of meningococcal disease arose across Rotherham district, four of whom were severely ill with serogroup C meningococcal septicaemia. Intense media interest, high levels of public concern, and anxieties caused by several 'false alarm' cases added to the challenge faced by a small health district. This article describes the epidemiology of the incident and policy decisions made, but focuses on the operational aspects of outbreak management (coordination, communication, and collaboration), an area often neglected in outbreak reports.

Adolescent↗
PubMed1997

The application of evidence-based priority setting in a District Health Authority.

BACKGROUND: Despite the current drive towards evidence-based medicine, it is not clear how commissioners actually use research findings in making decisions on priority setting. This study describes an attempt to directly introduce evidence on the effectiveness of interventions into the annual priority setting process of a District Health Authority (DHA). METHODS: Literature searches were undertaken on proposals for Health Authority funding. The identified literature was then critically appraised, and relevant information was used by members of the Department of Public Health to score the individual bids in terms of health gain. These scores were then fed into the priority setting process. RESULTS: A total of 144 proposals for funding were submitted. For 6.2 per cent of proposals there was strong evidence to support the intervention, for 21.2 per cent there was fair evidence in support, and for 38.1 per cent there was poor evidence. A search was not possible for 16.8 per cent of the proposals. There was a moderate correlation between the strength of evidence for the effectiveness of the proposal and initial scoring of the proposal for health gain (r = 0.41, p < 0.001). At the end of the priority setting process there was no correlation between strength of evidence and priority ranking (r = 0.01, p = 0.97). CONCLUSIONS: It is feasible, but difficult, to use information resources and critical assessment of research evidence as part of the priority setting process of a DHA. The research evidence did appear to influence the initial assessment of proposals. However, the strength of the research evidence was not associated with the priority choices made by the DHA in its purchasing plan.

Databases, Bibliographic↗
PubMed1997

Specialist outreach clinics in Sheffield: a faster tier of out-patient provision for the patients of fundholding GPs?

BACKGROUND: Little is known about the activity of the many new specialist outreach clinics in fundholding general practices that have emerged since the introduction of fundholding in 1991, though it has been claimed that specialist outreach clinics have shortened waiting times for fundholders' patients. This study describes the activity of specialist outreach clinics in fundholding practices in Sheffield, focusing on comparative waiting times between fundholding and non-fundholding practices. METHODS: A descriptive study was carried out using routine out-patient activity data and a listing of outreach clinics obtained from fundholding practices. RESULTS: Thirty-seven specialist outreach clinics were established in fundholding practices by November 1994; 23 in surgical specialties. In 1994-1995, for gynaecology, orthopaedics and general surgery, the leading outreach specialties, 22.5 per cent of fundholders' first attendances were in outreach clinics. In those three specialties, 87.0 per cent of patients in specialist outreach clinics in fundholding practices vs 67.1 per cent in hospital clinics were routine appointments, and 17.4 per cent vs 9.4 per cent, respectively, were added to an in-patient waiting list. The proportion of first attendees seen in less than three months was 97.0 per cent in specialist outreach clinics in fundholding practices vs 88.1 per cent in hospital clinics; 90.4 per cent for the patients of fundholders who had outreach clinics vs 85.2 per cent for fundholders who did not; 88.1 per cent for all fundholders' patients vs 88.6 per cent for non-fundholders' patients. CONCLUSIONS: The new specialist outreach service in fundholding practices in Sheffield is largely for surgical patients classified as routine patients. Although patients were seen more quickly in specialist outreach clinics, no overall inequality of waiting times between fundholding and non-fundholding practices was shown.

Adolescent↗
PubMed1995

Gastroenteritis associated with oysters.

An outbreak of gastroenteritis occurred in catering students attending three classes at a Yorkshire college in February 1994. The three classes were held on the Monday, Tuesday, and Thursday of the same week and had identical menus. Thirty-seven of the 90 students were affected. A cohort study, with a 94% response rate, showed a highly significant association of illness with the consumption of raw oysters grown in English coastal waters.

Animals↗